This mentored research career development award will train Dr. Deborah Thorpe in clinical outcomes research. The long term goal is to prepare her for independently funded, hypothesis-driven investigations that will test interventions designed to maintain mobility, activity and quality of life in adults with cerebral palsy (CP). Dr. Thorpe is an Assistant Professor at UNC in the Department of Allied Health Sciences, Division of Physical Therapy. Her primary mentor is Dr. Richard Henderson, an established orthopedic surgeon and researcher in the area of musculoskeletal conditions in CP. Dr. Thorpe's co-mentor is Dr. Margaret Turk, an established physical medicine and rehabilitation clinician-scientist from SUNY Upstate Medical University whose research focuses on the effects of aging in persons with CP. The application proposes a combined didactic and clinical research experience that will utilize the vast resources at the University of North Carolina at Chapel Hill as well as SUNY Upstate Medical University to foster Dr. Thorpe's demonstrated interest in clinical outcomes research and activity-based intervention. Drs. Dianne Damiano, Carol Giuliani, Robert McMurray and Laura Vogtle will also provide research advisement and expertise in the subject areas of CP and outcomes research. A two-part mentored research plan is proposed. There is a paucity of evidence addressing the development of secondary impairments and the efficacy of current interventions to address mobility, activity, and health related quality of life (HRQL) in adults with CP. To address these limitations in evidenced-based practice, the specific aims of this study are to: (1a) Characterize secondary impairments and nonimpairment-related factors in a cohort of adults with CP. (1b) Describe the relationships among secondary impairments, HRQL and activity and mobility levels in a cohort of adults with CP. (2) Determine the feasibility of an aquatic exercise intervention aimed at diminishing the severity of select secondary impairments and improving HRQL and activity level in a cohort of adults with CP. Aims 1a and 1b will collect demographic information and measure body composition, strength, pain, cardiorespiratory fitness and health related quality of life (HRQL) in order to better identify specific impairments, functional limitations and disability that will be the focus of future study. Aim 2 will establish the feasibility of a longitudinal aquatic resistive exercise intervention and evaluate its effects on strength, pain, cardiorespiratory fitness, activity level, economy of movement and HRQL. It is expected that aquatic resistive exercise will facilitate increased strength, reduced pain and improved cardiorespiratory fitness, thereby improving health related quality of life.